Tag Archives: insurance

Lumpy, Sneezy, Dopey and Doc (or Why Policies Can Suck It) – Part 3

 

Josephine Rae Born 8.16.11

Part 3:  Dopey

It occurred to me while planning this post that I may start out talking about my experience in the hospital and migrate to a conversation about depression.

Do not be alarmed.

I’m actually dreading this story.  You see, I haven’t allowed myself to revisit it for fear of that evil bastard, self-pity, to rear its head.  I think the moral is an important one though, so here is my third rant in the series:

When my daughter was born, she was a healthy 8 lb. 14 oz baby.  Not bad, right?  To us, she looked like a skinny little slip of a thing compared to my firstborn who tipped the scales at 10 lbs. 1 oz.  I felt a twinge of guilt that I hadn’t fed her enough or that my constant Benadryl or coffee habit had diminished her potential for Amazonian greatness.  Still, for five days early, nearly 9 lbs isn’t a bad birthweight.

Once in my hospital room, my nurse suggested I try to feed the sleeping baby.  I asked if I should wake her to do so and she gave a non-committal reply to “just try.”  I gave it a half-hearted effort because little Jellybean was completely cashed. Being born is hard!  Sadly, the next time the nurse came in, she informed me that my daughter’s blood sugar had gone below the hospital’s threshold for normal and that she had to go to the NICU.

I was incredulous.  I asked if I could just feed her and have the sugars tested again.  It seemed like a reasonable and logical approach.  (Before you dismiss my unprofessional medical opinion, when her sister, Ginormica, was born, the nurses sagely put a bottle of formula in Daddy’s hand and a tube taped to his finger so she could feed straight away.  This happened a few times before my milk came in and we were none the wiser about HER risk for low blood sugar.  The nurses simply mitigated it.)

This time, however, Dopey, as she will be henceforth referred to, mistakenly informed me that she “had” to take my daughter away but that I could visit her in the NICU to feed her whenever I wanted.  My daughter was then taken to the Intensive Care Unit for Newborns and put on monitors for her heart rate and blood oxygen levels.  She wasn’t given any formula.  She wasn’t put on a IV.

And she didn’t come back to my room for FIFTEEN HOURS.

There are several problems with this:

  1. Newborns should be with their mothers unless there is a serious medical risk that would prevent their proximity.
  2. The NICU was full of desperately sick babies on oxygen under dim lights and parents who look gutted by fear and desperation.
  3. I had just been sawed open like a magic trick except with actual blood – which regularly made its way to the NICU floor in macabre puddles when I arrived to nurse my newborn in hopes of springing her.
  4. Hospital policy increased the minimum blood sugar level requirement for my daughter to be released from the NICU above the level that got her locked up but didn’t apply any policy for regular feedings or timing of testing.  The nurses simply took her blood sugar on a schedule whether she’d been fed recently or not.  Three sufficient test readings were required to be released and if one reading dropped below the threshold, the testing started over from zero.  Talk about stacking the deck…

In hindsight, I should have fought harder to keep my daughter with me.

I should have told Dopey that she can suck it but she cannot take my daughter away.

I should have asked for the Floor manager, a Patient liaison, my OB, a Peditrician – ANYONE with sense enough to say, “let’s not overreact or follow the letter but distort the spirit of this new policy – this is a big, healthy baby who needs to eat.  Let’s feed her and see what happens” instead of “let’s take away this newborn because we have a new policy and I want to be a good rule follower.”

Anyone who knows me at all can tell you what I think of rule-followers.

I should have fought harder to exert my will in the interest of my and  my daughter’s well-being.  I should have asked more questions and challenged authority and raised a stink that would have put Dopey in hasty retreat.

I can hardly believe I dithered and fumbled and followed.  I blame the hormones; it’s the only logical explanation for behavior that is so wholly foreign to me.

To add insult to injury, Dopey actually wheeled the empty basinet back into my room after she delivered my daughter to the NICU saying, “I’m just going to leave this here.  You’re a C-section so you’re here for four days… she might be back by then.”

I can tell you now, though I wouldn’t have admitted it for fear of being committed, that I almost broke that day.  There was a moment when the world went unanimated and a crushing excess of emotion swirled up inside me.  My vision went black around the ridges and I choked on the air I was trying to breathe.  In that moment I feared that the me that is fun and outgoing and light-hearted would retreat permanently – into the recesses where fantasy and nightmares reside, where there is a running dialogue of self-loathing and paranoia and helplessness – into the lead-lined box of depression.

This story gets complicated because when I retell it, I feel a sense of injustice rising up like bile in my throat.  I was cheated.  Even worse, so was my daughter.  I don’t care that I had to get out of my hospital bed with a burning incision and stabbing abdominal pain, gushes of blood everytime I went vertical, and the annoying catheter bag that never seemed to be emptied in order to be wheeled to the NICU during my daughter’s incarceration.

I care that my newborn wasn’t in my arms or at arms-length for FIFTEEN OF HER FIRST TWENTY-FOUR HOURS.

I don’t forgive that nurse for her carelessness or callousness.

I don’t forgive the hospital for creating a policy that ignores the mother in the mother-baby equation in order to cover their proverbial ass or to charge insurance companies for something that can’t be refused – intensive care for a newborn baby as an offset for the increasing squeeze on their maternal care fees.

But I escaped with my daughter in tow.  My healthy, fat baby hardly left my arms for two weeks after that.  And when my husband mentioned that I might
have attachment issues that need to be discussed with a professional, I reluctantly let him hold his daughter… for a minute.

I don’t know why the dark water didn’t suck me under this time.  I remain guarded that it still might.  I can only point to this – that I mentally steer myself toward what I have, instead of what I haven’t.  The feeling of being cheated (and outrage at people’s moral bankruptcy) tamped down much of my pregnancy and new motherhood joy three years ago.  I didn’t compartmentalize the negativity of a toxic environment and it took me two years to rebound.  Now, I reign my mind into the here and now and wriggle back into its comforting softness to fill up the whole space so there isn’t room for any ‘what ifs’ or ‘whys?’ to suck the air out of my happy.

And I do it every day, over and over.  And I breathe.  And I cuddle my beautiful child and know that she is 1/3 of what matters to me most.

And that’s enough.

But my mistrust of healthcare and its policies aimed at maximum profit grows.  How about you?

Lumpy, Sneezy, Dopey and Doc (Or Why Policies can Suck It) – Part 2

Part 2:  Sneezy

In her first 2 years of life, my darling daughter, Calamity Jayne, had more than 20 ear infections.  It seems that every time she caught a cold, she got an ear infection.  And she caught a lot of colds.

I feel totally cheated by this injustice.

I nursed her for nine months – throwing caution and modesty to the wind by pumping in offices, airports, and hotel rooms.  I took nursing-lunches in our car when my uber-understanding hub drove down to my office to afford me baby time during my post-partum battle.

Yet my bub was a snotty, sneezy mess for much of her young life.  She had several ear infections that lasted months because the antibiotics we used to treat her didn’t cure the infection.

Pediatricians we saw offered little advice.

Instead, we were reassured that “kids get sick.”  I admit, I was comforted that this wasn’t my ‘fault.’  As a first-time parent, I was fairly convinced that I was doing it wrong.  (And by “it” I mean everything.)

We saw plenty of pediatricians.  This wasn’t a situation where one doctor was responsible for our inability to prevent or treat her ear infections.  Our Chicago practice has more than a dozen doctors on staff.  We love being able to get an appointment at any time and having the diversity of experience, thought, and treatment that all those doctors provide.  Our St. Louis practice was smaller but seemed wholly competent in their
treatment and fairly advanced in their technology and organization.

We thought we were doing everything we could.  And our doctors agreed.

Earlier this year, we saw a doctor at our Chicago practice in her 50s.  She took quite a long time with us (a rarity among all sick-care providers) and reviewed CJ’s charts all the way back to her birth.  She was really shocked at the volume of infections and the frequency with which we returned to the office.

She raised the red-flag.

She told us she suspected that the antibiotic courses we’d been given our daughter (non-penicillin because of an allergy) weren’t strong enough to kill the underlying sinus infection.  So, although the ear cleared with the single round, the sinus infection raged on and then landed right back in the ear(s).

This made sense.

She put us on back-to-back rounds of antibiotics.  Until the cough was gone (that pesky post-nasal drip from my childhood seems to have been inherited by Big Red), we kept re-upping the antibiotics.

Finally, after three rounds, the child was cough-free, sniffles free and ear pain free.

Around this time, my sage sister-in-law also raised the issue that no child this age should be doing so many rounds of antibiotics.  Drugs, as they say, are bad, mmkay?  Well, not ALL bad, but certainly this was a disproportionate amount of unnatural toxins for the itty-body of a toddler.  That, and she might just develop immunity to the only strain of antibiotics she can take leaving her susceptible to horrible sickness that most people would, well, sneeze at.

My sis also recommended that we see a specialist.  An Otolaryngologist.  So we got a recommendation, made an appointment, and saw a specialist.

The specialist asked us why we had waited so long to get our daughter seen.

Instead of “kids get sick,” we were told that CJ was having far too many infections and could absolutely benefit from getting grommets inserted to help with drainage.  We were also encouraged to hear that the surgery might improve her mood and manner considerably.

Earaches suck.
Calamity might very well be acting out because of her constant discomfort.

WTF.

Like any parent of a toddler wants to enjoy additional fits and general obnoxiousness just for giggles!

I hated the idea of putting my precious little baby girl under anesthesia, and my growing belly was wrecking havoc on my logic and emotional stability, but I didn’t see how I could justify not giving my daughter some relief.

So we had the surgery.

And I cried buckets when she went in and buckets more when she came out.

But she’s been ear pain free ever since… for six months.  And that’s a miracle.

So, my hub and I have asked ourselves… what did take so long?  Why didn’t we know to see a specialist and get the ear tubes done after the first six, ten, twelve, fifteen, etc. infections/ rounds of antibiotics?

Sadly and cynically, it seems the clear answer would be because our pediatricians don’t get paid if we stop coming to see them for ear infections.  And was the surgery necessary?  How can we know for certain?  But we do know that the Otolaryngologist wouldn’t get paid if she didn’t absolutely endorse her speciality.

Medicine for profit is bullshit.

It makes a mess of patient care and breeds mistrust.

I want to respect and trust medical professionals.  I want to know that they have my and my family’s HEALTH in their best interest – NOT what procedures are billable, NOT what drugs they are incentivized to promote, NOT what the insurance company covers at a higher percentage.

I don’t trust any of this is happening.

Medicine is enough of a guessing game without making patients wonder if they’re actually getting their doctor’s best recommendation or the best priced one?

The system is broken and it is making us broke.